1
|
Merlino L, Chiné A, Carletti G, Del Prete F, Codacci Pisanelli M, Titi L, Piccioni MG. Appendectomy and women’s reproductive outcomes: a review of the literature. Eur Surg 2021. [DOI: 10.1007/s10353-021-00703-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Summary
Background
The most frequent abdominal surgery performed for benign disease in females of fertile age is appendectomy, which remains among the most common surgeries and is a possible cause of peritoneal adhesions. The fact that appendectomy can cause adhesions may lead one to think that this may be a relevant risk factor for infertility; however, there is no universal agreement regarding the association between appendectomy and fertility. The aim of this review is to evaluate weather appendectomy may have a relevant impact on female fertility.
Methods
The search was conducted in PubMed and there was no limitation set on the date of publication. All studies regarding populations of female patients who had undergone appendectomy for inflamed appendix, perforated appendix, or negative appendix between childhood and the end of the reproductive period were included.
Results
Some authors believe that pelvic surgery can cause adhesions which can potentially lead to tubal infertility by causing tubal obstruction or by altering motility of fimbriae, tubal fluid secretion, and embryo transport. On the other hand, the most recent evidence reported that removal of the appendix seems to be associated with an increased pregnancy rate in large population studies.
Conclusion
Despite the existence of contrasting opinions concerning fertility after appendectomy, the most recent evidence suggests that appendectomy may actually lead to improved fertility and decreased time to pregnancy. Appendectomy seems to be correlated with improved fertility and higher pregnancy rates.
Collapse
|
2
|
Rubino C, Barbati F, Regoli M, Bencini E, Mattei A, Fierro F, Brizzi I, Indolfi G. Recurrent Bilateral Salpingitis in a Sexually Inactive Adolescent: Don't Forget about the Appendix. J Pediatr Adolesc Gynecol 2021; 34:217-219. [PMID: 33358895 DOI: 10.1016/j.jpag.2020.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Salpingitis is an acute inflammation of the fallopian tubes and is extremely uncommon in patients who are sexually inactive or premenarchal. CASE We describe a 15-year-old sexually inactive patient with recurrent bilateral salpingitis. After the second episode, she underwent an exploratory laparoscopy and was diagnosed with chronic appendicitis. SUMMARY AND CONCLUSION Appendicular involvement should be kept in mind in recurrent salpingitis episodes, especially if previous imaging studies do not show signs of appendicitis. Imaging studies should be repeated in experienced centers in case of recurrent episodes. Laparoscopy is the gold standard for the diagnosis of salpingitis and can confirm appendicular or other abdominal involvement. Early diagnosis can help to prevent recurrent episodes of salpingitis and thus reduce the risk of sequelae.
Collapse
Affiliation(s)
- Chiara Rubino
- Post-Graduate School of Pediatrics, University of Florence, Florence, Italy.
| | - Federica Barbati
- Post-Graduate School of Pediatrics, University of Florence, Florence, Italy
| | - Marta Regoli
- Pediatric Unit, Meyer Children's University Hospital, Florence, Italy
| | - Erica Bencini
- Pediatric Gynecology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Alberto Mattei
- Department of Minimally Invasive Gynecological Surgery, Centre Tuscany USL, Italy
| | - Francesca Fierro
- Radiology Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Ilaria Brizzi
- Pediatric Unit, Meyer Children's University Hospital, Florence, Italy
| | - Giuseppe Indolfi
- Department of NEUROFARBA, Meyer Children's University Hospital, University of Florence, Florence, Italy
| |
Collapse
|
3
|
Wang A, Hajmurad S, Khan M, Villarreal S. Development of Pelvic Inflammatory Disease after Ectopic Removal. Infect Dis Obstet Gynecol 2021; 2021:6668299. [PMID: 33531793 PMCID: PMC7837769 DOI: 10.1155/2021/6668299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 11/17/2022] Open
Abstract
Although ectopic pregnancy and pelvic inflammatory disease (PID) are separately commonly seen in practice, development of PID after surgical removal is rare. Here, we present the case of a 41-year-old female who was admitted for pelvic inflammatory disease diagnosed after laparoscopic salpingectomy for a ruptured ectopic pregnancy. Treatment required drainage of TOAs with interventional radiology and antibiotic treatment. This case report demonstrates how treatment of PID following ectopic pregnancy is complex and may require surgical- or radiology-guided drainage of infection in addition to common antibiotic treatment. Follow-up and duration of treatment are highlighted.
Collapse
Affiliation(s)
- Amanda Wang
- Department of OBGYN, University of Texas Medical Branch, Galveston, TX, USA
| | - Sema Hajmurad
- Department of OBGYN, University of Texas Medical Branch, Galveston, TX, USA
| | - Maryam Khan
- Department of OBGYN, University of Texas Medical Branch, Galveston, TX, USA
| | - Sarah Villarreal
- Department of OBGYN, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
4
|
Ji X, Wang C, Lim KG, Tan CC, Chong TC, Zhao R. Tunable Resistive Switching Enabled by Malleable Redox Reaction in the Nano-Vacuum Gap. ACS APPLIED MATERIALS & INTERFACES 2019; 11:20965-20972. [PMID: 31117430 DOI: 10.1021/acsami.9b02498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neuromorphic computing has emerged as a highly promising alternative to conventional computing. The key to constructing a large-scale neural network in hardware for neuromorphic computing is to develop artificial neurons with leaky integrate-and-fire behavior and artificial synapses with synaptic plasticity using nanodevices. So far, these two basic computing elements have been built in separate devices using different materials and technologies, which poses a significant challenge to system design and manufacturing. In this work, we designed a resistive device embedded with an innovative nano-vacuum gap between a bottom electrode and a mixed-ionic-electronic-conductor (MIEC) layer. Through redox reaction on the MIEC surface, metallic filaments dynamically grew within the nano-vacuum gap. The nano-vacuum gap provided an additional control factor for controlling the evolution dynamics of metallic filaments by tuning the electron tunneling efficiency, in analogy to a pseudo-three-terminal device, resulting in tunable switching behavior in various forms from volatile to nonvolatile switching in a single device. Our device demonstrated cross-functions, in particular, tunable neuronal firing and synaptic plasticity on demand, providing seamless integration for building large-scale artificial neural networks for neuromorphic computing.
Collapse
Affiliation(s)
- Xinglong Ji
- Department of Engineering Product Design , Singapore University of Technology and Design , 8 Somapah Road , Singapore 487372 , Singapore
| | - Chao Wang
- Department of Engineering Product Design , Singapore University of Technology and Design , 8 Somapah Road , Singapore 487372 , Singapore
| | - Kian Guan Lim
- Department of Engineering Product Design , Singapore University of Technology and Design , 8 Somapah Road , Singapore 487372 , Singapore
| | - Chun Chia Tan
- Department of Engineering Product Design , Singapore University of Technology and Design , 8 Somapah Road , Singapore 487372 , Singapore
| | - Tow Chong Chong
- Department of Engineering Product Design , Singapore University of Technology and Design , 8 Somapah Road , Singapore 487372 , Singapore
| | - Rong Zhao
- Department of Engineering Product Design , Singapore University of Technology and Design , 8 Somapah Road , Singapore 487372 , Singapore
| |
Collapse
|
5
|
Limberg J, Ginsburg H, Lala S, Tomita S. Recurrent Pelvic Infections and Salpingitis after Perforated Appendicitis. J Pediatr Adolesc Gynecol 2015; 28:e177-8. [PMID: 26342348 DOI: 10.1016/j.jpag.2015.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The effect of perforated appendicitis on the adnexa is an issue of concern and controversy. Long-term fertility studies have been conflicting. CASE We present the case of a patient with chronic pelvic infections, salpingitis, and hydrosalpinx after perforated appendicitis. SUMMARY AND CONCLUSION Magnetic resonance imaging was helpful in diagnosing a chronically obstructed fallopian tube, likely secondary to the dense adhesions from her previously treated perforated appendicitis. Salpingectomy relieved her symptoms of chronic pain and recurrent infections.
Collapse
Affiliation(s)
- Jessica Limberg
- Department of Surgery, Division of Pediatric Surgery, New York University Langone Medical Center, New York, New York
| | - Howard Ginsburg
- Department of Surgery, Division of Pediatric Surgery, New York University Langone Medical Center, New York, New York
| | - Shailee Lala
- Department of Radiology, Division of Pediatric Radiology, New York University Langone Medical Center, New York, New York
| | - Sandra Tomita
- Department of Surgery, Division of Pediatric Surgery, New York University Langone Medical Center, New York, New York.
| |
Collapse
|
6
|
Cabral MDI, Siqueira LM. Hydrosalpinx in Postmenarchal Nonsexually Active Girls: A Review of 6 Cases in a Children's Hospital. J Pediatr Adolesc Gynecol 2015; 28:e203-7. [PMID: 26117410 DOI: 10.1016/j.jpag.2015.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 06/15/2015] [Accepted: 06/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The objective of the study was to identify the presence of hydrosalpinx in postmenarchal nonsexually active girls in a children's hospital and to review the available literature on hydrosalpinx in this population. CASES In a tertiary care children's hospital, we performed a retrospective review of charts from January 1, 2000 to December 31, 2014 and identified six cases of hydrosalpinx in postmenarchal nonsexually active female adolescents ranging in age from 12 to 19 years old. The diagnosis of hydrosalpinx was made using imaging studies. Four of six patients were symptomatic at presentation, and two patients were diagnosed when seen for unrelated reasons. Five of these six girls had previous abdominopelvic surgery. Four girls were given empiric antibiotic treatment for presumed pelvic inflammatory disease related to hydrosalpinx. Two patients required surgical intervention that resulted in complete resolution of the hydrosalpinx. The oldest patient in the series underwent ultrasound-guided drainage of the pyo- and/or hydrosalpinx with subsequent recurrence with tubal ovarian abscess five months later. SUMMARY AND CONCLUSIONS The presence of hydrosalpinx might be discovered in the workup of pelvic pain in nonsexually active adolescents or on routine follow-up in patients with previous abdominal surgery, some of whom are asymptomatic. The underlying pathophysiology for hydrosalpinx in this population remains unclear. Among our cases, postsurgical adhesions appeared to be the most likely predisposing factor for tubular obstruction. Early detection and prompt diagnosis will allow for appropriate conservative or definitive treatment.
Collapse
Affiliation(s)
- Maria Demma I Cabral
- Division of Adolescent Medicine, Department of Pediatric Medicine, Nicklaus Children's Hospital, Miami Children's Health System, Miami, Florida.
| | - Lorena M Siqueira
- Division of Adolescent Medicine, Department of Pediatric Medicine, Nicklaus Children's Hospital, Miami Children's Health System, Miami, Florida
| |
Collapse
|
7
|
Kazmi Z, Gupta S. Best practice in management of paediatric and adolescent hydrosalpinges: a systematic review. Eur J Obstet Gynecol Reprod Biol 2015; 195:40-51. [PMID: 26476798 DOI: 10.1016/j.ejogrb.2015.09.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/17/2015] [Accepted: 09/25/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hydrosalpinx is a rare cause of abdominal pain in paediatric patients, though cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx due to ascending sexually transmitted infection. Hydrosalpinx can present mimicking an acute abdomen or can be asymptomatic. Management of paediatric hydrosalpinx varies, but often involves surgical removal of the affected tube. METHODS In June 2015, a literature search using relevant keywords was completed on MEDLINE and EMBASE databases to determine best management of paediatric hydrosalpinx. RESULTS We found 66 cases from 38 articles. Surgical intervention took place in 74% of cases (n=49). The most common surgical intervention was salpingectomy. In 3% of cases (n=2), nonsurgical medical management with hormonal therapy was utilized, with post-operative improvement in symptomology. In 23% of cases (n=15), conservative management was utilized: 2 of these cases torted, 4 cases persisted and 9 cases resolved. CONCLUSION Overall, the results of this review demonstrate that there are comparable outcomes between surgical, medical and conservative management. However, medical and conservative management was not often offered, and more research is needed on the subject.
Collapse
Affiliation(s)
- Zainab Kazmi
- University of Manchester School of Medicine, Stopford Building, Oxford Road, Manchester M13 9PT, United Kingdom.
| | - Sujata Gupta
- Women's Health Directorate, Royal Preston Hospital, Sharoe Green Lane North, Preston, Lancashire PR2 9HT, United Kingdom
| |
Collapse
|